OMB control number

End-Stage Renal Disease (ESRD) Network Semi-Annual Cost Report Forms and Supporting Regulations (CMS-685)

OMB 0938-0657 · HHS/CMS.

OMB 0938-0657

Submission of semi-annual cost reports allow CMS to review, compare, and project ESRD network costs. The reports are used as an early warning system to determine whether the networks are in danger of exceeding the total cost of the contract. Additionally, CMS can analyze line item costs to identify any significant aberations.

The latest form for End-Stage Renal Disease (ESRD) Network Semi-Annual Cost Report Forms and Supporting Regulations (CMS-685) expires 2023-05-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
CMS-685_Supporting_Statement_Part_A - final (3-2-2020).docx Supporting Statement A
End-Stage Renal Disease (ESRD) Network Semi-Annual Cost Report Forms and Supporting Regulations in 42 CFR 405.2110 and 42 CFR 405.2112 Instruction

All Historical Document Collections

202002-0938-012 Approved without change	Reinstatement without change of a previously approved collection	2020-03-03
201605-0938-007 Approved with change	Revision of a currently approved collection	2016-05-10
201304-0938-008 Approved without change	Extension without change of a currently approved collection	2013-04-30
201004-0938-006 Approved without change	Reinstatement without change of a previously approved collection	2010-04-19
200609-0938-001 Approved without change	Extension without change of a currently approved collection	2006-09-13
200308-0938-001 Approved without change	Extension without change of a currently approved collection	2003-08-05
200010-0938-007 Approved without change	Extension without change of a currently approved collection	2000-10-20
199709-0938-010 Approved without change	Extension without change of a currently approved collection	1997-09-18
199407-0938-003 Approved without change	New collection (Request for a new OMB Control Number)	1994-07-12